Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 146615 | NY |
NPI | 1104896901 |
---|---|
Provider Name | Stuart M Lichtman |
First Address | New York, NY 10017-6706 |
Second Address | Commack, NY 11725-5404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B20621 | (02) |